Page Purpose
The purpose of this topic is to educate clinicians on available measures of lower extremity strength, in addition to manual muscle testing, that could better benefit the patient. Details about the 30 second chair stand (30CST) and its assessment of functional leg strength will be found below and will include testing, scoring, and reliability/validity information. All information contained in this Wikispace can be supplemented with additional resources from the Work Cited section.

Objectives
  • The reader will understand the importance of using the 30 second chair stand
  • The reader will learn the validity and reliability of this measure in the geriatric population
  • The reader will understand how to administer the 30 second chair stand
  • The reader will understand the scoring of this measure
  • The reader will understand the benefits of the 30 second chair stand over the 5 times sit to stand in the geriatric population

30 second chair stand
The 30 second chair stand is used to screen lower extremity leg strength and endurance. The evaluative test requires a stop watch and upright armless chair with a 17 inch seat height. No training is required prior to performing this test and a time limit of 30 seconds is the total time that the test takes for completion. Upon completion of this test, clinicians can determine if poor leg strength is a contributing or predisposing factor for falls or other health conditions.

Supplies Required
  1. Stopwatch
  2. Upright armless chair with a 17 inch seat height
  3. Wall space

Scoring of the 30CST
The following are below average scores for gender and age groups. Below average scores indicate a high risk for falls.
Age
Men
Women
60-64
<14
<12
65-69
<12
<11
70-74
<12
<10
75-79
<11
<10
80-84
<10
<9
85-89
<8
<8
90-94
<7
<4

Notes:
If a patient must use their arms to stand up from the chair to complete the test, they are scored a 0.
A correct stand includes crossing the arms and coming to a full stand and sitting down completely between stands.

Patients Tested
The test has been validated with older adults at various physical activity and physical independence levels; however, it is often used in patients who are over age 65, have arthritis, or have been diagnosed with a movement disorder.

Validity
Test validity is still being researched and no normative validity has been determined.

30CST vs 5 times sit to stand
The 30CST was developed to eliminate the floor effect that could be caused by the 5 times sit to stand. Instead of assuming that a patient will be able to stand a total of five times, the 30CST chooses to count the number of times a patient is capable of standing. This allows the 30CST to assess a wide variety of abilities, from scores ranging from 0 to very fit individuals.

Pros and Cons
  • Takes 30 seconds to administer
  • No floor effects as are seen in the 5x sit to stand
  • Excellent inter-rater reliability in community dwelling elderly r = 0.95 (95% CI = 0.84-0.97)
  • Excellent test-retest reliability in community dwelling elderly r = 0.89 (95% CI = 0.79-0.93)
  • No training is required for administration

Final Thoughts
The 30CST provides important information to the clinician regarding the patient’s functional abilities; however, in addition to these findings, “differences in the frailty level of a subject can [also] be found by evaluating the specific way the 30-s CST cycles are carried out.” By looking at the patient holistically, clinicians will be able to retrieve a lot of information by doing this quick and easy test.

For the CDC handout on the 30 second chair stand test, please click on the following link:
http://www.cdc.gov/steadi/pdf/30_second_chair_stand_test-a.pdf

References

1. “Association between Physical Fitness and Successful Aging in Taiwanese Older Adults.” National Center for Biotechnology Information. Available at: http://www.ncbi.nlm.nih.gov/pubmed/26963614. Accessed May 11, 2016.

2. “Differences in Functional Fitness Among Older Adults With and Without Risk of Falling.” National Center for Biotechnology Information. Available at: http://www.ncbi.nlm.nih.gov/pubmed/27021835. Accessed May 11, 2016

3. Millor N, Lecumberri P, Gomez M, Martinez-Ramirez A, Izquierdo M. “An evaluation of the 30-s chair stand test in older adults: frailty detection based on kinematic parameters from a single inertial unit.” Journal of NeuroEngineering and Rehabilitation. Available at: __http://www.ncbi.nim.nih.gov/pmc/articles/pmc3735415/__. Accessed May 11, 2016.

4. “Repeated Chair Stands as a Measure of Lower Limb Strength in Sexagenarian Women.” The Journals of Gerontology: Series A. Available at: http://biomedgerontology.oxfordjournals.org/content/59/11/1207.full. Accessed May 11, 2016.

5. “Rehab Measures - 30 second sit to stand test.” The Rehabilitation Measures Database. Available at: http://www.rehabmeasures.org/lists/rehabmeasures/dispform.aspx?id=1122. Accessed May 11, 2016.

6. Schneider DL. “Preventing Falls: Time for Action.” Today's Geriatric Medicine. 6(6):34–34.